( ) 28 kg/ m 2, OSAHS, BMI < 24 kg/ m 2 10

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1 http: / / www. cjrccm. com 435 ;, ( sleep apneahypopnea syndrome, SAHS) 20 80,, SAHS /, SAHS, [ 1 ] SAHS ( obstructive sleep apnea-hypopnea syndrome, OSAHS) OSAHS [ 2-4 ], 50% 92% OSAHS, 30% 50% OSAHS [ 5-6 ] 2006, OSAHS 56. 2% [ 7 ] OSAHS,,, [ 8-1 2] [ 1 3], [ 7, ],, OSAHS DOI: / :, net; : yahoo. com. cn;, com;, cbynew ( central sleep apnea syndrome, CSAS) ( sleep hypopnea syndrome, SHS) OSAHS, OSAHS 1. ( 1) [ 20 ] : ( body mass index, BMI) 28 kg/ m 2, OSAHS, BMI < 24 kg/ m 2 10 ( 2) :,, 70 ( 3) : ( 4) : ( ) ( 5) OSAHS ( 6) / [ 1 9] ( 7) ( 8) : ( ) 2. OSAHS : OSAHS,,,,,,,, [ 20] [ ] 1. OSAHS :

2 436 Chin J Respir Crit Care Med, September 2013, Vol. 12, No. 5 http: / /www. cjrccm. com,,,,,,,, ;, -, 2, 2. ( 1), :, ( 2 ) : 24 h ( ambulatory blood pressure monitoring, ABPM), [ 7, ] ( 3) :,, OSAHS [ 25-26],, ( 4) : ABPM ( polysomnography, PSG),, 3. :, ( 1) ( 2) ( 3),, ( 4),, ( 5) ( 6) ( 7) ( 8) ( 9) ( 10), BMI = ( kg) / 2 ( m 2 ), ;, OSAHS: 1. ( PSG) ( 1 ) PSG : OSAHS [ 2 7], ( EEG) ( EOG) ( EMG) ( SpO 2 ) EMG 7 h PSG : OSAHS,, ;, ; ; ;, ; OSAHS ( 2) PSG : 2 4 h PSG, 3 h ( CPAP), : ( AHI) > 15 / h,,, ( rapid eye movement, REM) CPAP >3 h, CPAP, PSG CPAP ( 3) PSG :, 2 4 h ( ) OSAHS, 2. : ( 1) ( ) ( ) :,,

3 http: / / www. cjrccm. com 437,,,, ( 2) : Epworth ( Epworth sleepiness scale, ESS) ( 1), 8, , 1 8, 9 15, 16 24,, ESS 1 Epworth ( ) ( ) ( 1 h) ( ) ( 0) ( 1) ( 2) ( 3) : ( multiple sleep latency test, MSIX) 2 h 1, 30 min,, < 5 min, 5 10 min, >10 min, 3. :, PSG, SpO 2 + SpO SpO 2 + PSG, OSAHS,, h ( ABPM) :,, PSG ABPM, 5. : X X ( ) 1. : 2010 [ 2 8], 140 /90 mm Hg ( 1 mm Hg = kpa), 135 /85 mm Hg, 24 h 130 /80 mm Hg 2. OSAHS : PSG [ 29 ] ( ESS 9 ),, AHI 5 / h AHI, ( ESS < 9 ), AHI 10 /h AHI 5 / h, 1 1 [ ] 3. : OSAHS,, OSAHS 4. : AHI SpO 2, AHI SpO 2 OSAHS, AHI, SpO 2, 2 2 OSAHS AHI( / h) SpO 2 ( % ) > > 30 < :, SpO 2 [ ], ( 1) 2,

4 438 Chin J Respir Crit Care Med, September 2013, Vol. 12, No. 5 http: / /www. cjrccm. com ( 2), ( 15 min) ( 3), ( 4) ( ESS 9 ) ( 5) SpO 2, ( ODI) 10 / h ( 6) 1 1 6, PSG 6. :, ;, 1 1, OSAHS, OSAHS, OSAHS,,,, 1. : OSAHS, 2. : OSAHS,, OSAHS 3. : OSAHS, CPAP ( AutoCPAP) ( BiPAP), CPAP, CO 2 BiPAP,,,,, COPD BiPAP CPAP OSAHS,,, [ 3 4], [ 35] CPAP,,, CPAP CPAP : OSAHS ( AHI > 15 / h) ; OSAHS( AHI 5 15 /h), ( ), ; ; OSAHS : CPAP, CPAP, CPAP,, SpO 2, PSG, AHI < 5 / h, SpO 2 >90% ;,

5 http: / / www. cjrccm. com 439 ;, 4. : OSAHS, CPAP, CPAP :, ;,, 5. [ 36 ] :, ( UPPP) AHI < 20 / h, AHI > 20 / h OSAHS, CPAP 1 2, UPPP,,, CPAP 6. ( 1) :,,,,,,, 24 h,,,,,,, : ( ACEI / ARB), ACEI 24 h, ( NREM REM),, AHI, [ 37 ], ( ),, [ 3 8] ( CCB), REM [ 3 9] : - : OSAHS, -,, - :, OSAHS,, REM, REM [ 4 0] ( 2) :,,, 1. : OSAHS( CPAP ),,,, CPAP,, 2. CPAP : CPAP, CPAP, CPAP, 3, 6 12 CPAP, CPAP : 3 6 PSG,,, CPAP 1.,,, ABPM PSG,

6 440 Chin J Respir Crit Care Med, September 2013, Vol. 12, No. 5 http: / /www. cjrccm. com, 2., AHI 5 15 / h, ; OSAHS( AHI 5 15 / h), OSAHS ( AHI > 15 / h), CPAP ; AHI < 15 /h, 3. ACEI ARB, - ( RASI) CCB, ABPM PSG,, 4., CPAP, : : : : ( ) : : 1 Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA, 2003, 289 : Peppard PE, Young T, Palta M, et al. Prospective study of the association between sleep-disordered breathing and hypertension. New Engl J Med, 2000, 342: Bixler EO, Vgontzas AN, Lin HM, et al. Association of hypertension and sleep-disordered breathing. Arch Inter Med, 2000, 160: ,,,. 20., 2007, 17: Drager LF, Genta PR, Pedrosa RP, et al. Characteristics and predictors of obstructive sleep apnea in patients with systemic hypertension. Am J Cardiol, 2010, 105: Worsnop CJ, Naughton MT, Barter CE, et al. The prevalence of obstructive sleep apnea in hypertensives. Am J Respir Crit Care Med, 1998, 157: , 2007, 30: , 2010, 30: ,,,.., 2007, 35: ,,,.., 2012, 40: ,,,.., 2012, 20: ,,,.., 2011, 19: ,.., 2009, 89: Epstein LJ, Kristo D, Strollo PJ Jr, et al. Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med, 2009, 5: ,2012, 35: ,,,.., 2011, 19: Iber C, Ancoli-Israel S, Chesson AL Jr, et al. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Westchester, IL: American Academy of Sleep Medicine, ,,,.., 2011, 19: ,,,.., 2007, 15: ,.., 2010, 9 : ,.., 2009, 15 : Li NF, Yao XG, Zhu J, et al. Higher levels of plasma TNF-alpha and neuropeptide Y in hypertensive patients with obstructive sleep apnea syndrome. Clin Exp Hypertens, 2010, 32: ,.., 2004, 2: ,,,..

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